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Rueda JC, Peláez-Ballestas I, Angarita JI, Santos AM, Pinzon C, Saldarriaga EL, Rueda JM, Forero E, Saaibi DL, Pavía PX, Mantilla MJ, Rodríguez-Salas G, Santacruz JC, Rueda I, Cardiel MH, Londono J. Clinical Diagnosis of Chikungunya Infection: An Essential Aid in a Primary Care Setting Where Serological Confirmation Is Not Available. Trop Med Infect Dis 2023; 8:tropicalmed8040213. [PMID: 37104340 PMCID: PMC10146408 DOI: 10.3390/tropicalmed8040213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
Background: Chikungunya virus (CHIKV) diagnosis has become a challenge for primary care physicians in areas where the Zika virus and/or Dengue virus are present. Case definitions for the three arboviral infections overlap. Methods: A cross-sectional analysis was carried out. A bivariate analysis was made using confirmed CHIKV infection as the outcome. Variables with significant statistical association were included in an agreement consensus. Agreed variables were analyzed in a multiple regression model. The area under the receiver operating characteristic (ROC) curve was calculated to determine a cut-off value and performance. Results: 295 patients with confirmed CHIKV infection were included. A screening tool was created using symmetric arthritis (4 points), fatigue (3 points), rash (2 points), and ankle joint pain (1 point). The ROC curve identified a cut-off value, and a score ≥ 5.5 was considered positive for identifying CHIKV patients with a sensibility of 64.4% and a specificity of 87.4%, positive predictive value of 85.5%, negative predictive value of 67.7%, area under the curve of 0.72, and an accuracy of 75%. Conclusion: We developed a screening tool for CHIKV diagnosis using only clinical symptoms as well as proposed an algorithm to aid the primary care physician.
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Affiliation(s)
- Juan C. Rueda
- Biosciences Programme, Faculty of Medicine and Engineering, Universidad de La Sabana, Chía 53753, Colombia
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía 53753, Colombia
| | - Ingris Peláez-Ballestas
- Rheumatology Unit, Hospital General de México “Doctor Eduardo Liceaga”, Mexico City 06729, Mexico
| | - Jose-Ignacio Angarita
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía 53753, Colombia
| | - Ana M. Santos
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía 53753, Colombia
| | - Carlos Pinzon
- Departamento de Investigación Clínica, Facultad de Medicina, Universidad de La Sabana, Chía 53753, Colombia
| | - Eugenia-Lucia Saldarriaga
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía 53753, Colombia
| | - Jorge M. Rueda
- Rheumatology Unit, Centro Médico Imbanaco, Universidad Libre, Cali 760042, Colombia
| | - Elias Forero
- Rheumatology and Internal Medicine Department, Universidad del Norte, Barranquilla 081007, Colombia
| | - Diego L. Saaibi
- Reumatología Ubit, Centro Médico Carlos Ardila Lulle, Bucaramanga 681004, Colombia
| | - Paula X. Pavía
- Unidad de Investigación Científica, Hospital Militar Central, Bogotá 110231, Colombia
| | - Marta Juliana Mantilla
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía 53753, Colombia
- Rheumatology Department, Hospital Militar Central, Bogotá 110231, Colombia
| | - Gustavo Rodríguez-Salas
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía 53753, Colombia
- Rheumatology Department, Hospital Militar Central, Bogotá 110231, Colombia
| | - Juan Camilo Santacruz
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía 53753, Colombia
- Rheumatology Department, Hospital Militar Central, Bogotá 110231, Colombia
| | - Igor Rueda
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía 53753, Colombia
- Rheumatology Department, Hospital Militar Central, Bogotá 110231, Colombia
| | - Mario H. Cardiel
- Centro de Investigación Clínica de Morelia SC, Morelia 58280, Mexico
| | - John Londono
- Grupo de Espondiloartropatías, Rheumatology Department, Universidad de La Sabana, Chía 53753, Colombia
- Rheumatology Department, Hospital Militar Central, Bogotá 110231, Colombia
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Chikungunya Manifestations and Viremia in Patients WhoPresented to the Fever Clinic at Bangkok Hospital for Tropical Diseases during the 2019 Outbreak in Thailand. Trop Med Infect Dis 2021; 6:tropicalmed6010012. [PMID: 33494514 PMCID: PMC7924391 DOI: 10.3390/tropicalmed6010012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/11/2021] [Accepted: 01/15/2021] [Indexed: 02/06/2023] Open
Abstract
Chikungunya virus is an Alphavirus belonging to the family Togaviridae that is transmitted to humans by an infected Aedes mosquito. Patients develop fever, inflammatory arthritis, and rash during the acute stage of infection. Although the illness is self-limiting, atypical and severe cases are not uncommon, and 60% may develop chronic symptoms that persist for months or even for longer durations. Having a distinct periodical epidemiologic outbreak pattern, chikungunya virus reappeared in Thailand in December 2018. Here, we describe a cohort of acute chikungunya patients who had presented to the Bangkok Hospital for Tropical Diseases during October 2019. Infection was detected by a novel antigen kit and subsequently confirmed by real-time RT-PCR using serum collected at presentation to the Fever Clinic. Other possible acute febrile illnesses such as influenza, dengue, and malaria were excluded. We explored the sequence of clinical manifestations at presentation during the acute phase and associated the viral load with the clinical findings. Most of the patients were healthy individuals in their forties. Fever and arthralgia were the predominant clinical manifestations found in this patient cohort, with a small proportion of patients with systemic symptoms. Higher viral loads were associated with arthralgia, and arthralgia with the involvement of the large joints was more common in female patients.
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Evidence of chikungunya virus infection among febrile patients in northwest Ethiopia. Int J Infect Dis 2020; 104:183-188. [PMID: 33373719 DOI: 10.1016/j.ijid.2020.12.057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/17/2020] [Accepted: 12/20/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Chikungunya virus (CHIKV) infection has similar clinical presentations to malaria. Hence, febrile illnesses are often misdiagnosed as malaria. Therefore, this study aimed to generate baseline data on CHIKV infection in northwest Ethiopia where malaria is endemic. METHODS A hospital-based cross-sectional study was conducted among febrile patients presenting at the Metema and Humera Kahsay Abera hospitals from March 2016 to May 2017. Data on socio-demographic, clinical presentations, and possible risk factors were collected using a structured questionnaire. Serum samples were screened for immunoglobulin-M (IgM) and IgG antibodies to CHIKV infections using enzyme-linked immunosorbent assay. Logistic regression analysis was used to determine the strength of association. RESULTS Of 586 samples screened, the overall seroprevalence of CHIKV infection was 23%. Of the total study participants, 22.5% had CHIKV-specific IgM, indicating recent CHIKV infection. During monsoon and post-monsoon periods, increased prevalence of anti-CHIKV IgM seropositivity was found. The most common clinical presentation observed was fever, followed by headache and joint pain. Men had twice the likelihood of CHIKV infection. The presence of stagnant water near the residence almost doubled the risk for CHIKV infection. CONCLUSIONS Most of the study participants had recent infection with CHIKV, suggesting the need to design disease prevention and intervention strategies.
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Foeller ME, Nosrat C, Krystosik A, Noel T, Gérardin P, Cudjoe N, Mapp-Alexander V, Mitchell G, Macpherson C, Waechter R, LaBeaud AD. Chikungunya infection in pregnancy - reassuring maternal and perinatal outcomes: a retrospective observational study. BJOG 2020; 128:1077-1086. [PMID: 33040457 DOI: 10.1111/1471-0528.16562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate pregnancy and neonatal outcomes, disease severity, and mother-to-child transmission of pregnant women with Chikungunya infection (CHIKV). DESIGN Retrospective observational study. SETTING Grenada. POPULATION Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible. METHODS This descriptive study investigated 731 mother-infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA. MAIN OUTCOME MEASURES Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity. RESULTS Of 416 mother-infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (μ = 898 days, σ = 277 days) compared with infections outside of pregnancy (μ = 1064 days, σ = 244 days) (P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother-to-child transmission occurred in two (1.3%) mother-infant pairs and two of eight intrapartum infections (25%). CONCLUSION CHIKV infection during pregnancy may be protective against long-term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother-to-child transmission of CHIKV. TWEETABLE ABSTRACT Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.
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Affiliation(s)
- M E Foeller
- Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA
| | - C Nosrat
- Program in Human Biology, Stanford University, Stanford, CA, USA
| | - A Krystosik
- Division of Infectious Disease, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA
| | - T Noel
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - P Gérardin
- INSERM CIC1410, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Réunion.,Unité Mixte 134 PIMIT (INSERM 1187, CNRS 9192, IRD 249, Université de La Réunion), Sainte Clotilde, Réunion
| | - N Cudjoe
- Windward Islands Research and Education Foundation, True Blue, Grenada
| | - V Mapp-Alexander
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - G Mitchell
- Ministry of Health, St. Georges, Grenada
| | - C Macpherson
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - R Waechter
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - A D LaBeaud
- Division of Infectious Disease, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA
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Waechter R, Ingraham E, Evans R, Cudjoe N, Krystosik A, Isaac R, Watts A, Noël T, Landon B, Fernandes M, Mapp-Alexander V, Suresh P, Mitchell G, Macpherson C, Gérardin P, LaBeaud AD. Pre and postnatal exposure to Chikungunya virus does not affect child neurodevelopmental outcomes at two years of age. PLoS Negl Trop Dis 2020; 14:e0008546. [PMID: 33017393 PMCID: PMC7535067 DOI: 10.1371/journal.pntd.0008546] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/30/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The 2005-06 chikungunya virus (CHIKV) outbreak in La Réunion suggested that mothers could transmit CHIKV to their neonates while viremic during the intrapartum period, and more than half of the infected neonates showed impaired neurodevelopment at two years of age. However, data sparsity precluded an overview of the developmental impact of vertical infection within the whole prenatal period. OBJECTIVE & METHODS The current study assessed two-year old children born to mothers who were infected during the 2014 CHIKV outbreak in Grenada to determine the neurodevelopmental impact of perinatal CHIKV infection throughout gestation. Mother and child infection status were confirmed by serologic testing (IgG and IgM) for CHIKV. Cognitive, fine motor, gross motor, language and behavioral outcomes were assessed at two years of age on the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA). RESULTS No differences in neurodevelopmental outcomes were observed between two-year-old children born to mothers infected with CHIKV during gestation (n = 149) and those born to mothers not infected with CHIKV (n = 161). No differences were found in INTER-NDA scores between children infected with CHIKV (n = 47) and children not infected with CHIKV (n = 592). Likewise, there were no differences between children infected with CHIKV post-partum (n = 19) versus children not infected with CHIKV (n = 592). CONCLUSION Our findings suggest that children exposed and/or infected with CHIKV outside of the intrapartum period experience no significant neurodevelopmental delay at two years of age, as measured by the INTER-NDA, compared to their unexposed and/or uninfected peers. These results complement those of previous studies which showed a neurodevelopmental risk only for children infected during the intrapartum period, while the mother was highly viremic. These results might be reassuring for women of childbearing age and public health officials in CHIKV-endemic regions.
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Affiliation(s)
- Randall Waechter
- Department of Neuroscience and Physiology and Behavioral Sciences, School of Medicine, St. George’s University, St. George’s, Grenada, West Indies
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
| | - Erinique Ingraham
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
| | - Roberta Evans
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
| | - Nikita Cudjoe
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
| | - Amy Krystosik
- Stanford University, School of Medicine, Department of Pediatrics, Division of Infectious Disease, California, United States of America
| | - Rashida Isaac
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
| | - Ashlee Watts
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
| | - Trevor Noël
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
- Office of Research, St. George’s University, St. George’s, Grenada, West Indies
| | - Barbara Landon
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
- Psychological Services Center, St. George’s University, St. George’s, Grenada, West Indies
| | - Michelle Fernandes
- Faculty of Medicine, Department of Paediatrics, University Hospitals Southampton, University of Southampton, Southampton, United Kingdom
- Nuffield Department of Women’s & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Veronica Mapp-Alexander
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
- School of Veterinary Medicine, St. George’s University, St. George’s, Grenada, West Indies
| | - Priyanka Suresh
- Stanford University, School of Medicine, Department of Pediatrics, Division of Infectious Disease, California, United States of America
| | - George Mitchell
- Office of Chief Medical Officer, Ministry of Health, St, George’s, Grenada, West Indies
| | - Calum Macpherson
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
- Office of Research, St. George’s University, St. George’s, Grenada, West Indies
| | - Patrick Gérardin
- INSERM CIC1410, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Réunion / Unité Mixte 134 PIMIT (Université de La Réunion, CNRS 9192, INSERM U1187, IRD 249), Sainte Clotilde, Réunion
| | - A. Desiree LaBeaud
- Stanford University, School of Medicine, Department of Pediatrics, Division of Infectious Disease, California, United States of America
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Olson MF, Garcia-Luna S, Juarez JG, Martin E, Harrington LC, Eubanks MD, Badillo-Vargas IE, Hamer GL. Sugar Feeding Patterns for Aedes aegypti and Culex quinquefasciatus (Diptera: Culicidae) Mosquitoes in South Texas. JOURNAL OF MEDICAL ENTOMOLOGY 2020; 57:1111-1119. [PMID: 32043525 PMCID: PMC7334892 DOI: 10.1093/jme/tjaa005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Indexed: 05/15/2023]
Abstract
Effective mosquito surveillance and management depend on a thorough understanding of the biology and feeding patterns unique to species and sex. Given that a propensity to sugar feed is necessary for some mosquito surveillance and newer control strategies, we sought to document the amount of total sugar in wild Aedes aegypti (L.) and Culex quinquefasciatus (Say) captured from five different locations in the Lower Rio Grande Valley (LRGV) of South Texas over 2 yr. We used Biogents Sentinel 2 (BGS2) traps in year 1 and aspirators, BGS2, and CDC resting traps in years 2 and 3 to collect adult mosquitoes. The hot anthrone test was used to quantify total sugar content in each mosquito. Additionally, the cold and hot anthrone tests were used to distinguish fructose content from total sugars for mosquitoes captured in 2019. Overall, Ae. aegypti females had significantly lower total sugar content than Ae. aegypti males as well as both sexes of Cx. quinquefasciatus. However, the percentage of Ae. aegypti positive for fructose consumption was four to eightfold higher than Ae. aegypti previously reported in other regions. The difference between locations was significant for males of both species, but not for females. Seasonality and trapping method also revealed significant differences in sugar content of captured mosquitoes. Our results reinforce that sugar feeding in female Ae. aegypti is less than Cx. quinquefasciatus, although not absent. This study provides necessary data to evaluate the potential effectiveness of sugar baits in surveillance and control of both Ae. aegypti and Cx. quinquefasciatus mosquitoes.
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Affiliation(s)
- Mark F Olson
- Department of Entomology, Texas A&M University, College Station, TX
| | | | - Jose G Juarez
- Department of Entomology, Texas A&M University, College Station, TX
| | - Estelle Martin
- Department of Entomology, Texas A&M University, College Station, TX
| | | | - Micky D Eubanks
- Department of Entomology, Texas A&M University, College Station, TX
| | | | - Gabriel L Hamer
- Department of Entomology, Texas A&M University, College Station, TX
- Corresponding author, e-mail:
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Olson MF, Ndeffo-Mbah ML, Juarez JG, Garcia-Luna S, Martin E, Borucki MK, Frank M, Estrada-Franco JG, Rodríguez-Pérez MA, Fernández-Santos NA, Molina-Gamboa GDJ, Carmona Aguirre SD, Reyes-Berrones BDL, Cortés-De la cruz LJ, García-Barrientos A, Huidobro-Guevara RE, Brussolo-Ceballos RM, Ramirez J, Salazar A, Chaves LF, Badillo-Vargas IE, Hamer GL. High Rate of Non-Human Feeding by Aedes aegypti Reduces Zika Virus Transmission in South Texas. Viruses 2020; 12:E453. [PMID: 32316394 PMCID: PMC7232486 DOI: 10.3390/v12040453] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/21/2022] Open
Abstract
Mosquito-borne viruses are emerging or re-emerging globally, afflicting millions of people around the world. Aedes aegypti, the yellow fever mosquito, is the principal vector of dengue, Zika, and chikungunya viruses, and has well-established populations across tropical and subtropical urban areas of the Americas, including the southern United States. While intense arboviral epidemics have occurred in Mexico and further south in the Americas, local transmission in the United States has been minimal. Here, we study Ae. aegypti and Culex quinquefasciatus host feeding patterns and vertebrate host communities in residential environments of South Texas to identify host-utilization relative to availability. Only 31% of Ae. aegypti blood meals were derived from humans, while 50% were from dogs and 19% from other wild and domestic animals. In Cx. quinquefasciatus, 67% of blood meals were derived from chicken, 22% came from dogs, 9% from various wild avian species, and 2% from other mammals including one human, one cat, and one pig. We developed a model for the reproductive number, R0, for Zika virus (ZIKV) in South Texas relative to northern Mexico using human disease data from Tamaulipas, Mexico. We show that ZIKV R0 in South Texas communities could be greater than one if the risk of human exposure to Ae. aegypti bites in these communities is at least 60% that of Northern Mexico communities. The high utilization of non-human vertebrates and low risk of human exposure in South Texas diminishes the outbreak potential for human-amplified urban arboviruses transmitted by Ae. aegypti.
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Affiliation(s)
- Mark F. Olson
- Department of Entomology, Texas A&M University, College Station, TX 77843, USA; (M.F.O.); (J.G.J.); (S.G.-L.); (E.M.); (I.E.B.-V.)
| | - Martial L. Ndeffo-Mbah
- Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA;
| | - Jose G. Juarez
- Department of Entomology, Texas A&M University, College Station, TX 77843, USA; (M.F.O.); (J.G.J.); (S.G.-L.); (E.M.); (I.E.B.-V.)
| | - Selene Garcia-Luna
- Department of Entomology, Texas A&M University, College Station, TX 77843, USA; (M.F.O.); (J.G.J.); (S.G.-L.); (E.M.); (I.E.B.-V.)
| | - Estelle Martin
- Department of Entomology, Texas A&M University, College Station, TX 77843, USA; (M.F.O.); (J.G.J.); (S.G.-L.); (E.M.); (I.E.B.-V.)
| | - Monica K. Borucki
- Biosciences and Biotechnology Division, Chemistry, Materials and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; (M.K.B.); (M.F.)
| | - Matthias Frank
- Biosciences and Biotechnology Division, Chemistry, Materials and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; (M.K.B.); (M.F.)
| | - José Guillermo Estrada-Franco
- Instituto Politécnico Nacional, Centro de Biotecnología Genómica, Cd. Reynosa 88710, Tamaulipas, Mexico; (J.G.E.-F.); (M.A.R.-P.); (N.A.F.-S.)
| | - Mario A. Rodríguez-Pérez
- Instituto Politécnico Nacional, Centro de Biotecnología Genómica, Cd. Reynosa 88710, Tamaulipas, Mexico; (J.G.E.-F.); (M.A.R.-P.); (N.A.F.-S.)
| | - Nadia A. Fernández-Santos
- Instituto Politécnico Nacional, Centro de Biotecnología Genómica, Cd. Reynosa 88710, Tamaulipas, Mexico; (J.G.E.-F.); (M.A.R.-P.); (N.A.F.-S.)
| | - Gloria de Jesús Molina-Gamboa
- Secretary of Health of the State of Tamaulipas, Epidemiology Directorate, Cd. Victoria 87000, Tamaulipas, Mexico; (G.d.J.M.-G.); (S.D.C.A.); (B.d.L.R.-B.); (L.J.C.-D.l.c.); (A.G.-B.); (R.E.H.-G.); (R.M.B.-C.)
| | - Santos Daniel Carmona Aguirre
- Secretary of Health of the State of Tamaulipas, Epidemiology Directorate, Cd. Victoria 87000, Tamaulipas, Mexico; (G.d.J.M.-G.); (S.D.C.A.); (B.d.L.R.-B.); (L.J.C.-D.l.c.); (A.G.-B.); (R.E.H.-G.); (R.M.B.-C.)
| | - Bernardita de Lourdes Reyes-Berrones
- Secretary of Health of the State of Tamaulipas, Epidemiology Directorate, Cd. Victoria 87000, Tamaulipas, Mexico; (G.d.J.M.-G.); (S.D.C.A.); (B.d.L.R.-B.); (L.J.C.-D.l.c.); (A.G.-B.); (R.E.H.-G.); (R.M.B.-C.)
| | - Luis Javier Cortés-De la cruz
- Secretary of Health of the State of Tamaulipas, Epidemiology Directorate, Cd. Victoria 87000, Tamaulipas, Mexico; (G.d.J.M.-G.); (S.D.C.A.); (B.d.L.R.-B.); (L.J.C.-D.l.c.); (A.G.-B.); (R.E.H.-G.); (R.M.B.-C.)
| | - Alejandro García-Barrientos
- Secretary of Health of the State of Tamaulipas, Epidemiology Directorate, Cd. Victoria 87000, Tamaulipas, Mexico; (G.d.J.M.-G.); (S.D.C.A.); (B.d.L.R.-B.); (L.J.C.-D.l.c.); (A.G.-B.); (R.E.H.-G.); (R.M.B.-C.)
| | - Raúl E. Huidobro-Guevara
- Secretary of Health of the State of Tamaulipas, Epidemiology Directorate, Cd. Victoria 87000, Tamaulipas, Mexico; (G.d.J.M.-G.); (S.D.C.A.); (B.d.L.R.-B.); (L.J.C.-D.l.c.); (A.G.-B.); (R.E.H.-G.); (R.M.B.-C.)
| | - Regina M. Brussolo-Ceballos
- Secretary of Health of the State of Tamaulipas, Epidemiology Directorate, Cd. Victoria 87000, Tamaulipas, Mexico; (G.d.J.M.-G.); (S.D.C.A.); (B.d.L.R.-B.); (L.J.C.-D.l.c.); (A.G.-B.); (R.E.H.-G.); (R.M.B.-C.)
| | - Josue Ramirez
- Health Department, City of Harlingen, TX 78550, USA;
| | - Aaron Salazar
- Hidalgo County Health & Human Services, Edinburg, TX 78539, USA;
| | - Luis F. Chaves
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Apartado Postal, Tres Ríos, Cartago 4-2250, Costa Rica;
| | - Ismael E. Badillo-Vargas
- Department of Entomology, Texas A&M University, College Station, TX 77843, USA; (M.F.O.); (J.G.J.); (S.G.-L.); (E.M.); (I.E.B.-V.)
| | - Gabriel L. Hamer
- Department of Entomology, Texas A&M University, College Station, TX 77843, USA; (M.F.O.); (J.G.J.); (S.G.-L.); (E.M.); (I.E.B.-V.)
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Omatola CA, Onoja BA, Fassan PK, Osaruyi SA, Iyeh M, Samuel MA, Haruna PU. Seroprevalence of chikungunya virus infection in five hospitals within Anyigba, Kogi State of Nigeria. Braz J Infect Dis 2020; 24:1-6. [PMID: 32001210 PMCID: PMC9392021 DOI: 10.1016/j.bjid.2020.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 11/21/2019] [Accepted: 01/07/2020] [Indexed: 11/23/2022] Open
Abstract
Febrile illnesses in developing countries are often misdiagnosed as malaria or typhoid fever. Although arboviral infections have similar clinical symptoms, they are usually not screened because of limited resources and the fact that there are several viruses in this group. Chikungunya virus (CHIKV) has been isolated in parts of Nigeria, but there is no documented evidence of the infection in Kogi State. This study determined seroprevalence of active and past CHIKV infection among febrile patients who tested negative for malaria and typhoid fever. Sera from 243 febrile patients were screened for CHIKV IgG and IgM using an immunochromatographic test kit. Clinical and socio-demographic variables were collected using a structured questionnaire. Recent CHIKV infection was observed in 5.8% of the study participants while 25.1% had IgG antibodies demonstrating previous infection. Significant associations were observed between seropositivity and age of participants (p < 0.001), sex (p = 0.044), marital status (p = 0.002), and occupation (p < 0.001). Clinical symptoms such as fever, joint pain, and headache were significantly associated with seropositivity. This study identified recent CHIKV infection in Anyigba. Therefore, there is need for routine screening of febrile patients and molecular characterization to determine the nature of circulating strains.
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Affiliation(s)
| | - Bernard A Onoja
- University of Ibadan, College of Medicine, Department of Virology, Nigeria
| | - Peter K Fassan
- Kogi State University, Department of Microbiology, Anyigba, Nigeria
| | | | - Mercy Iyeh
- Kogi State University, Department of Microbiology, Anyigba, Nigeria
| | - Matthew A Samuel
- Kogi State University, Department of Microbiology, Anyigba, Nigeria
| | - Peace U Haruna
- Kogi State University, Department of Microbiology, Anyigba, Nigeria
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Fitzpatrick DM, Hattaway LM, Hsueh AN, Ramos-Niño ME, Cheetham SM. PCR-Based Bloodmeal Analysis of Aedes aegypti and Culex quinquefasciatus (Diptera: Culicidae) in St. George Parish, Grenada. JOURNAL OF MEDICAL ENTOMOLOGY 2019; 56:1170-1175. [PMID: 31245825 PMCID: PMC6595504 DOI: 10.1093/jme/tjz037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Indexed: 05/12/2023]
Abstract
Blood-feeding patterns of mosquitoes affect the transmission and maintenance of arboviral diseases. In the Caribbean, Aedes aegypti (L.) and Culex quinquefasciatus Say mosquitoes are the dominant mosquito species in developed areas. However, no information is available on the bloodmeal hosts of these invasive vectors in Grenada, where arboviral pathogens such as dengue, chikungunya, and Zika viruses cause significant human suffering. To this end, Ae. aegypti and Cx. quinquefasciatus mosquitoes were investigated from five semirural locations near houses in St. George's Parish, from 2017 to 2018. Polymerase chain reaction was conducted on DNA extracted from individual blood-fed mosquitoes using vertebrate-specific cytochrome b primers. The 32 Ae. aegypti bloodmeals included humans (70%), mongooses (18%), domestic dogs (6%), a domestic cat (3%), and an unidentified bird (3%). Thirty-seven Cx. quinquefasciatus mosquitoes took bloodmeals from seven species of birds (51%), humans (27%), domestic cats (8%), iguanas (5%), a domestic dog (3%), a rat (3%), and a common opossum (3%). The high percentage of human bloodmeal hosts in our study, especially by the normally anthropophilic Ae. aegypti, is expected. The bloodmeal sources and the percentage of nonhuman bloodmeals (30%) taken by Ae. aegypti are comparable to other studies. The large range of hosts may be explained in part by the semirural nature of most local housing. Accordingly, this may contribute to an exchange of pathogens between domestic, peridomestic, and sylvatic transmission cycles.
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Affiliation(s)
- Daniel M Fitzpatrick
- Department of Pathobiology, School of Veterinary Medicine, St. George’s University, Grenada, West Indies
| | - Lindsey M Hattaway
- Department of Pathobiology, School of Veterinary Medicine, St. George’s University, Grenada, West Indies
| | - Andy N Hsueh
- Department of Pathobiology, School of Veterinary Medicine, St. George’s University, Grenada, West Indies
| | - Maria E Ramos-Niño
- Department of Microbiology, School of Medicine, St. George’s University, Grenada, West Indies
| | - Sonia M Cheetham
- Department of Pathobiology, School of Veterinary Medicine, St. George’s University, Grenada, West Indies
- Corresponding author, e-mail:
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Abstract
Chikungunya virus (CHIKV) is an alphavirus that is primarily transmitted by Aedes species mosquitoes. Though reports of an illness consistent with chikungunya date back over 200 years, CHIKV only gained worldwide attention during a massive pandemic that began in East Africa in 2004. Chikungunya, the clinical illness caused by CHIKV, is characterized by a rapid onset of high fever and debilitating joint pain, though in practice, etiologic confirmation of CHIKV requires the availability and use of specific laboratory diagnostics. Similar to infections caused by other arboviruses, CHIKV infections are most commonly detected with a combination of molecular and serological methods, though cell culture and antigen detection are reported. This review provides an overview of available CHIKV diagnostics and highlights aspects of basic virology and epidemiology that pertain to viral detection. Although the number of chikungunya cases has decreased since 2014, CHIKV has become endemic in countries across the tropics and will continue to cause sporadic outbreaks in naive individuals. Consistent access to accurate diagnostics is needed to detect individual cases and initiate timely responses to new outbreaks.
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Grossi-Soyster EN, Lee J, King CH, LaBeaud AD. The influence of raw milk exposures on Rift Valley fever virus transmission. PLoS Negl Trop Dis 2019; 13:e0007258. [PMID: 30893298 PMCID: PMC6443189 DOI: 10.1371/journal.pntd.0007258] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/01/2019] [Accepted: 02/23/2019] [Indexed: 02/07/2023] Open
Abstract
Rift Valley fever virus (RVFV) is a zoonotic phlebovirus that can be transmitted to humans or livestock by mosquitoes or through direct contact with contaminated bodily fluids and tissues. Exposure to bodily fluids and tissues varies by types of behaviors engaged for occupational tasks, homestead responsibilities, or use in dietary or therapeutic capacities. While previous studies have included milk exposures in their analyses, their primary focus on livestock exposures has been on animal handling, breeding, and slaughter. We analyzed data from multiple field surveys in Kenya with the aim of associating RVFV infection to raw milk exposures from common animal species. Of those with evidence of prior RVFV infection by serology (n = 267), 77.2% engaged in milking livestock compared to 32.0% for 3,956 co-local seronegative individuals (p < 0.001), and 86.5% of seropositive individuals consumed raw milk compared to 33.4% seronegative individuals (p < 0.001). Individuals who milked and also consumed raw milk had greater odds of RVFV exposure than individuals whose only contact to raw milk was through milking. Increased risks were associated with exposure to milk sourced from cows (p < 0.001), sheep (p < 0.001), and goats (p < 0.001), but not camels (p = 0.98 for consuming, p = 0.21 for milking). Our data suggest that exposure to raw milk may contribute to a significant number of cases of RVFV, especially during outbreaks and in endemic areas, and that some animal species may be associated with a higher risk for RVFV exposure. Livestock trade is regulated to limit RVFV spread from endemic areas, yet further interventions designed to fully understand the risk of RVFV exposure from raw milk are imperative.
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Affiliation(s)
- Elysse N. Grossi-Soyster
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, United States of America
- * E-mail:
| | - Justin Lee
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, United States of America
| | - A. Desiree LaBeaud
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, United States of America
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Rueda JC, Santos AM, Angarita JI, Giraldo RB, Saldarriaga EL, Ballesteros Muñoz JG, Forero E, Valencia H, Somoza F, Martin-Arsanios D, Quintero EJ, Reyes-Martinez V, Padilla D, Cuervo FM, Peláez-Ballestas I, Cardiel MH, Pavía PX, Londono J. Demographic and clinical characteristics of chikungunya patients from six Colombian cities, 2014-2015. Emerg Microbes Infect 2019; 8:1490-1500. [PMID: 31631794 PMCID: PMC6819954 DOI: 10.1080/22221751.2019.1678366] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/04/2019] [Indexed: 02/07/2023]
Abstract
In 2014, the chikungunya virus reached Colombia for the first time, resulting in a nationwide epidemic. The objective of this study was to describe the demographics and clinical characteristics of suspected chikungunya cases. Chikungunya infection was confirmed by enzyme-linked immunosorbent assay and 548 patients where included in the study. Of these patients, 295 were positive for antibodies against chikungunya (53.8%), and 27.6% (151/295) were symptomatic for chikungunya infection, with a symptomatic:asymptomatic ratio of 1.04:1. Factors associated with infection included low income and low socio-economic strata (odds ratio [OR]: 1.8; 95% confidence interval [CI]: 1.0-3.2, p = 0.003 and OR: 2.1; CI: 1.3-3.4, p = 0.002, respectively). Confirmed symptomatic cases were associated with symmetric arthritis (OR: 11.7; CI: 6.0-23.0, p < 0.001) of ankles (OR: 8.5; CI: 3.5-20.9, p < 0.001), hands (OR: 8.5; CI: 3.5-20.9, p < 0.001), feet (OR: 6.5; CI: 2.8-15.3, p < 0.001), and wrists (OR: 17.3; CI: 2.3-130.5, p < 0.001). Our study showed that poverty is associated with chikungunya infection. Public health strategies to prevent and control chikungunya should focus on poorer communities that are more vulnerable to infection. The rate of asymptomatic infections among confirmed cases was 48.8%. However, those with symptoms displayed a characteristic rheumatic clinical picture, which could help differentiate chikungunya infection from other endemic viral diseases.
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Affiliation(s)
- Juan C. Rueda
- Biosciences Doctoral Programme, Faculty of Medicine and Engineering, Universidad de La Sabana, Chía, Colombia
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Ana M. Santos
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Jose-Ignacio Angarita
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Rodrigo B. Giraldo
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | | | | | - Elías Forero
- Department of Rheumatology and Internal Medicine, Universidad del Norte, Barranquilla, Colombia
| | - Hugo Valencia
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Francisco Somoza
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Daniel Martin-Arsanios
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Elias-Josué Quintero
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Viviana Reyes-Martinez
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Diana Padilla
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Francy M. Cuervo
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | | | | | - Paula X. Pavía
- Unidad de Investigación Científica, Hospital Militar Central, Bogotá, Colombia
| | - John Londono
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
- Department of Rheumatology, Hospital Militar Central, Bogotá, Colombia
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Mascarenhas M, Garasia S, Berthiaume P, Corrin T, Greig J, Ng V, Young I, Waddell L. A scoping review of published literature on chikungunya virus. PLoS One 2018; 13:e0207554. [PMID: 30496207 PMCID: PMC6264817 DOI: 10.1371/journal.pone.0207554] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 11/01/2018] [Indexed: 12/13/2022] Open
Abstract
Chikungunya virus (CHIKV) has caused several major epidemics globally over the last two decades and is quickly expanding into new areas. Although this mosquito-borne disease is self-limiting and is not associated with high mortality, it can lead to severe, chronic and disabling arthritis, thereby posing a heavy burden to healthcare systems. The two main vectors for CHIKV are Aedes aegypti and Aedes albopictus (Asian tiger mosquito); however, many other mosquito species have been described as competent CHIKV vectors in scientific literature. With climate change, globalization and unfettered urban planning affecting many areas, CHIKV poses a significant public health risk to many countries. A scoping review was conducted to collate and categorize all pertinent information gleaned from published scientific literature on a priori defined aspects of CHIKV and its competent vectors. After developing a sensitive and specific search algorithm for the research question, seven databases were searched and data was extracted from 1920 relevant articles. Results show that CHIKV research is reported predominantly in areas after major epidemics have occurred. There has been an upsurge in CHIKV publications since 2011, especially after first reports of CHIKV emergence in the Americas. A list of hosts and vectors that could potentially be involved in the sylvatic and urban transmission cycles of CHIKV has been compiled in this scoping review. In addition, a repository of CHIKV mutations associated with evolutionary fitness and adaptation has been created by compiling and characterizing these genetic variants as reported in scientific literature.
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Affiliation(s)
- Mariola Mascarenhas
- National Microbiology Laboratory at Guelph, Public Health Agency of Canada, Guelph, Ontario, Canada
| | - Sophiya Garasia
- National Microbiology Laboratory at Guelph, Public Health Agency of Canada, Guelph, Ontario, Canada
| | - Philippe Berthiaume
- National Microbiology Laboratory at St. Hyacinthe, Public Health Agency of Canada, St. Hyacinthe, Quebec, Canada
| | - Tricia Corrin
- National Microbiology Laboratory at Guelph, Public Health Agency of Canada, Guelph, Ontario, Canada
| | - Judy Greig
- National Microbiology Laboratory at Guelph, Public Health Agency of Canada, Guelph, Ontario, Canada
| | - Victoria Ng
- National Microbiology Laboratory at Guelph, Public Health Agency of Canada, Guelph, Ontario, Canada
| | - Ian Young
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
| | - Lisa Waddell
- National Microbiology Laboratory at Guelph, Public Health Agency of Canada, Guelph, Ontario, Canada
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Contopoulos-Ioannidis D, Newman-Lindsay S, Chow C, LaBeaud AD. Mother-to-child transmission of Chikungunya virus: A systematic review and meta-analysis. PLoS Negl Trop Dis 2018; 12:e0006510. [PMID: 29897898 PMCID: PMC6075784 DOI: 10.1371/journal.pntd.0006510] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 08/03/2018] [Accepted: 05/08/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Chikungunya virus (CHIKV) is an emerging arboviral infection with a global distribution and may cause fetal and neonatal infections after maternal CHIKV-infections during gestation. METHODOLOGY We performed a systematic review to evaluate the risk for: a) mother-to-child transmission (MTCT), b) antepartum fetal deaths (APFD), c) symptomatic neonatal disease, and d) neonatal deaths from maternal CHIKV-infections during gestation. We also recorded the neonatal clinical manifestations after such maternal infections (qualitative data synthesis). We searched PubMed (last search 3/2017) for articles, of any study design, with any of the above outcomes. We calculated the overall risk of MTCT, APFDs and risk of symptomatic neonatal disease by simple pooling. For endpoints with ≥5 events in more than one study, we also synthesized the data by random-effect-model (REM) meta-analysis. PRINCIPAL FINDINGS Among 563 identified articles, 13 articles from 8 cohorts were included in the quantitative data synthesis and 33 articles in the qualitative data synthesis. Most cohorts reported data only on symptomatic rather than on all neonatal infections. By extrapolation also of these data, the overall pooled-MTCT-risk across cohorts was at least 15.5% (206/1331), (12.6% by REMs). The pooled APFD-risk was 1.7% (20/1203); while the risk of CHIKV-confirmed-APFDs was 0.3% (3/1203). Overall, the pooled-risk of symptomatic neonatal disease was 15.3% (203/1331), (11.9% by REMs). The pooled risk of symptomatic disease was 50.0% (23/46) among intrapartum vs 0% (0/712) among antepartum/peripartum maternal infections. Infected newborns, from maternal infections during gestation were either asymptomatic or presented within their first week of life, but not at birth, with fever, irritability, hyperalgesia, diffuse limb edema, rashes and occasionally sepsis-like illness and meningoencephalitis. The pooled-risk of neonatal death was 0.6% (5/832) among maternal infections and 2.8% (5/182) among neonatal infections; long-term neurodevelopmental delays occurred in 50% of symptomatic neonatal infections. CONCLUSIONS/SIGNIFICANCE Published cohorts with data on the risk to the fetus and/or newborn from maternal CHIKV-infections during gestation were sparse compared to the number of recently reported CHIKV-infection outbreaks worldwide; however perinatal infections do occur, at high rates during intrapartum period, and can be related to neonatal death and long-term disabilities.
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Affiliation(s)
- Despina Contopoulos-Ioannidis
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Shoshana Newman-Lindsay
- Department of Pediatrics, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Camille Chow
- Department of Internal Medicine, St. Agnes Medical Center, Fresno, CA, United States of America
| | - A. Desiree LaBeaud
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, United States of America
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Galán-Huerta K, Martínez-Landeros E, Delgado-Gallegos J, Caballero-Sosa S, Malo-García I, Fernández-Salas I, Ramos-Jiménez J, Rivas-Estilla A. Molecular and Clinical Characterization of Chikungunya Virus Infections in Southeast Mexico. Viruses 2018; 10:248. [DOI: https:/doi.org/10.3390/v10050248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Molecular and Clinical Characterization of Chikungunya Virus Infections in Southeast Mexico. Viruses 2018; 10:v10050248. [PMID: 29747416 PMCID: PMC5977241 DOI: 10.3390/v10050248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/29/2018] [Accepted: 04/30/2018] [Indexed: 12/28/2022] Open
Abstract
Chikungunya fever is an arthropod-borne infection caused by Chikungunya virus (CHIKV). Even though clinical features of Chikungunya fever in the Mexican population have been described before, there is no detailed information. The aim of this study was to perform a full description of the clinical features in confirmed Chikungunya-infected patients and describe the molecular epidemiology of CHIKV. We evaluated febrile patients who sought medical assistance in Tapachula, Chiapas, Mexico, from June through July 2015. Infection was confirmed with molecular and serological methods. Viruses were isolated and the E1 gene was sequenced. Phylogeny reconstruction was inferred using maximum-likelihood and maximum clade credibility approaches. We studied 52 patients with confirmed CHIKV infection. They were more likely to have wrist, metacarpophalangeal, and knee arthralgia. Two combinations of clinical features were obtained to differentiate between Chikungunya fever and acute undifferentiated febrile illness. We obtained 10 CHIKV E1 sequences that grouped with the Asian lineage. Seven strains diverged from the formerly reported. Patients infected with the divergent CHIKV strains showed a broader spectrum of clinical manifestations. We defined the complete clinical features of Chikungunya fever in patients from Southeastern Mexico. Our results demonstrate co-circulation of different CHIKV strains in the state of Chiapas.
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Huits R, De Kort J, Van Den Berg R, Chong L, Tsoumanis A, Eggermont K, Bartholomeeusen K, Ariën KK, Jacobs J, Van Esbroeck M, Bottieau E, Cnops L. Chikungunya virus infection in Aruba: Diagnosis, clinical features and predictors of post-chikungunya chronic polyarthralgia. PLoS One 2018; 13:e0196630. [PMID: 29709007 PMCID: PMC5927412 DOI: 10.1371/journal.pone.0196630] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/16/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Chikungunya virus (CHIKV) emerged in Aruba for the first time in 2014. We studied the clinical presentation of acute CHIKV infection and the contribution of serologic and molecular assays to its diagnosis. In a cohort of confirmed CHIKV cases, we analysed the frequency, duration and predictors of post-chikungunya chronic polyarthralgia (pCHIK-CPA), defined as joint pains lasting longer than 6 weeks or longer than 1 year. METHODOLOGY Patient sera obtained within 10 days of symptom onset were tested for CHIKV, using an indirect immunofluorescence test for the detection of CHIKV-specific Immunoglobulin M (IgM) and post-hoc, by reverse-transcription polymerase chain reaction (RT-PCR). CHIKV was isolated from selected samples and genotyped. For confirmed CHIKV cases, clinical data from chart review were complemented by a Telephone survey, conducted 18-24 months after diagnosis. When joint pain was reported, the duration, presence of inflammatory signs, type and number of joints affected, were recorded. Joint involvement was scored according to the 2010 'American College of Rheumatology/ European League Against Rheumatism' criteria for seronegative rheumatoid arthritis (ACR-score). Risk factors for pCHIK-CPA were identified by logistic regression. PRINCIPAL FINDINGS Acute CHIKV infection was diagnosed in 269 of 498 sera, by detection of IgM (n = 105), by RT-PCR (n = 59), or by both methods (n = 105). Asian genotype was confirmed in 7 samples. Clinical data were complete for 171 of 248 (69.0%) patients, aged 15 years or older (median 49.4 [35.0-59.6]). The female-to-male ratio was 2.2. The main acute symptoms were arthralgia (94%), fever (85%), myalgia (85%), headache (73%) and rash (63%). In patients with arthralgia (n = 160), pCHIK-CPA longer than 6 weeks was reported by 44% and longer than 1 year by 26% of cases. Inflammatory signs, stiffness, edema and redness were frequent (71%, 39% and 21%, respectively). Joints involved were knees (66%), ankles (50%), fingers (52%), feet (46%), shoulders (36%), elbows (34%), wrists (35%), hips (31%), toes (28.1%) and spine (28.1%). Independent predictors of pCHIK-CPA longer than 1 year were female gender (OR 5.9, 95%-CI [2.1-19.6]); high ACR-score (7.4, [2.7-23.3]), and detection of CHIKV-RNA in serum beyond 7 days of symptom onset (6.4, [1.4-34.1]. CONCLUSIONS We identified 269 CHIKV patients after the first outbreak of Asian genotype CHIKV in Aruba in 2014-2015. RT-PCR yielded 59 (28%) additional CHIKV diagnoses compared to IgM antibody detection alone. Arthralgia, fever and skin rash were the dominant acute phase symptoms. pCHIK-CPA longer than 1 year affected 26% of cases and was predicted by female gender, high ACR-score and CHIKV-RNA detection beyond 7 days of symptom onset.
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Affiliation(s)
- Ralph Huits
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jaclyn De Kort
- Department of Internal Medicine, Horacio Oduber Hospital, Oranjestad, Aruba
| | | | - Luis Chong
- Landslaboratorium Aruba, Oranjestad, Aruba
| | - Achilleas Tsoumanis
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Kaat Eggermont
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Koen Bartholomeeusen
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Kevin K Ariën
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Microbiology and Immunology, University of Leuven, Leuven, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lieselotte Cnops
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Clinical, Serological, and Molecular Observations from a Case Series Study during the Asian Lineage Zika Virus Outbreak in Grenada during 2016. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2018; 2018:4635647. [PMID: 29623138 PMCID: PMC5829423 DOI: 10.1155/2018/4635647] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 10/22/2017] [Indexed: 12/03/2022]
Abstract
This paper describes the spatial and temporal distribution of cases, demographic characteristics of patients, and clinical manifestations of Zika virus (ZIKV) during the 2016 outbreak in Grenada. The first reported case was recorded in St. Andrew Parish in April, and the last reported case was seen in November, with peak transmission occurring in the last week of June, based on test results. Data were collected from a total of 514 patients, of whom 207 (40%) tested positive for ZIKV. No evidence was found that testing positive for ZIKV infection was related to age, gender, or pregnancy status. Clinical presentation with rash (OR = 2.4, 95% CI = 1.5 to 3.7) or with lymphadenopathy (OR = 1.7, 95% CI = 1.0 to 2.9) were the only reported symptoms consistent with testing positive for ZIKV infection. During the Zika outbreak, the infection rate was 20 clinical cases per 10,000 in the population compared to 41 cases per 10,000 during the chikungunya outbreak in Grenada in 2014 and 17 cases per 10,000 during the dengue outbreak in 2001-2002. Even though the country has employed vector control programs, with no apparent decrease in infection rates, it appears that new abatement approaches are needed to minimize morbidity in future arbovirus outbreaks.
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Danis-Lozano R, Díaz-González EE, Trujillo-Murillo KDC, Caballero-Sosa S, Sepúlveda-Delgado J, Malo-García IR, Canseco-Ávila LM, Salgado-Corsantes LM, Domínguez-Arrevillaga S, Torres-Zapata R, Gómez-Cruz O, Fernández-Salas I. Clinical characterization of acute and convalescent illness of confirmed chikungunya cases from Chiapas, S. Mexico: A cross sectional study. PLoS One 2017; 12:e0186923. [PMID: 29065182 PMCID: PMC5655440 DOI: 10.1371/journal.pone.0186923] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 10/10/2017] [Indexed: 01/06/2023] Open
Abstract
Background The emerging chikungunya virus (CHIKV), is an arbovirus causing intense outbreaks in North America. The situation in Mexico is alarming, and CHIKV threatens to spread further throughout North America. Clinical and biological features of CHIKF outbreaks in Mexico have not been well described; thus, we conducted a cross sectional study of a CHIKV outbreak in Chiapas, Southern Mexico to further characterize these features. Methodology/Principal findings We collected blood samples from patients suspected of having chikungunya fever (CHIKF) who presented to Clinical Hospital ISSSTE Dr. Roberto Nettel in Tapachula, Chiapas, Mexico. In addition to the clinical examination, real-time polymerase chain reaction (PCR) standardized for the Asian Chikungunya lineage and/or enzyme-linked immunosorbent assay for immunoglobulin M (IgM) were used to confirm CHIKV diagnosis. Of a total of 850 patients who presented with probably CHIKV at Hospital “Dr. Roberto Nettel”, 112 probable CHIKF cases were enrolled in this study from November 2014- June 2015, of which 95 patients (84.8%) were CHIKV positive and 17 were negative (15.2%). Of these 95 CHIKV positive patients, 62 were positive by real-time reverse transcriptase PCR (+qRT-PCR); and 33 were seropositive to +IgM with a negative qRT-PCR. The most frequent symptoms reported were fever (100%), headache (82.3%), polyarthralgia (72.1%), and exanthem (82.3%). Biological abnormalities observed during CHIKV infection were lymphopenia (41.1%), leukopenia (51.6%), elevated transaminases (30.5%-46.3%) and high LDH (46.3%) and CRP (60.0%). Conclusion Clinical and biological data obtained from this study is providing more useful information for benchmarking purposes with outbreaks from different parts of the world and would be helpful for better patient care and treatment.
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Affiliation(s)
- Rogelio Danis-Lozano
- Centro Regional de Investigación en Salud Pública, Instituto Nacional de Salud Pública, Tapachula, Chiapas, México
| | - Esteban Eduardo Díaz-González
- Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
- Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Karina del Carmen Trujillo-Murillo
- Hospital Regional de Alta Especialidad “Ciudad Salud”, Secretaría de Salud, Tapachula, Chiapas, México
- Facultad de Ciencias Químicas, Universidad Autónoma de Chiapas, Tapachula, Chiapas, México
| | - Sandra Caballero-Sosa
- Clínica Hospital “Dr. Roberto Nettel”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, México
| | - Jesús Sepúlveda-Delgado
- Hospital Regional de Alta Especialidad “Ciudad Salud”, Secretaría de Salud, Tapachula, Chiapas, México
| | - Iliana Rosalía Malo-García
- Centro Regional de Investigación en Salud Pública, Instituto Nacional de Salud Pública, Tapachula, Chiapas, México
| | - Luis Miguel Canseco-Ávila
- Hospital Regional de Alta Especialidad “Ciudad Salud”, Secretaría de Salud, Tapachula, Chiapas, México
- Facultad de Ciencias Químicas, Universidad Autónoma de Chiapas, Tapachula, Chiapas, México
| | - Luis Manuel Salgado-Corsantes
- Clínica Hospital “Dr. Roberto Nettel”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, México
| | - Sergio Domínguez-Arrevillaga
- Hospital Regional de Alta Especialidad “Ciudad Salud”, Secretaría de Salud, Tapachula, Chiapas, México
- Facultad de Ciencias Químicas, Universidad Autónoma de Chiapas, Tapachula, Chiapas, México
| | - Raúl Torres-Zapata
- Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
| | - Omar Gómez-Cruz
- Hospital Regional de Alta Especialidad “Ciudad Salud”, Secretaría de Salud, Tapachula, Chiapas, México
| | - Ildefonso Fernández-Salas
- Centro Regional de Investigación en Salud Pública, Instituto Nacional de Salud Pública, Tapachula, Chiapas, México
- Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
- Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
- * E-mail:
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Recommendations of the Brazilian Society of Rheumatology for diagnosis and treatment of Chikungunya fever. Part 1 - Diagnosis and special situations. REVISTA BRASILEIRA DE REUMATOLOGIA 2017; 57 Suppl 2:421-437. [PMID: 28751131 DOI: 10.1016/j.rbre.2017.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 05/22/2017] [Indexed: 01/26/2023] Open
Abstract
Chikungunya fever has become a relevant public health problem in countries where epidemics occur. Until 2013, only imported cases occurred in the Americas, but in October of that year, the first cases were reported in Saint Marin island in the Caribbean. The first autochthonous cases were confirmed in Brazil in September 2014; until epidemiological week 37 of 2016, 236,287 probable cases of infection with Chikungunya virus had been registered, 116,523 of which had serological confirmation. Environmental changes caused by humans, disorderly urban growth and an ever-increasing number of international travelers were described as the factors responsible for the emergence of large-scale epidemics. Clinically characterized by fever and joint pain in the acute stage, approximately half of patients progress to the chronic stage (beyond 3 months), which is accompanied by persistent and disabling pain. The aim of the present study was to formulate recommendations for the diagnosis and treatment of Chikungunya fever in Brazil. A literature review was performed in the MEDLINE, SciELO and PubMed databases to ground the decisions for recommendations. The degree of concordance among experts was established through the Delphi method, involving 2 in-person meetings and several online voting rounds. In total, 25 recommendations were formulated and divided into 3 thematic groups: (1) clinical, laboratory and imaging diagnosis; (2) special situations; and (3) treatment. The first 2 themes are presented in part 1, and treatment is presented in part 2.
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Affiliation(s)
- David M Vu
- Department of Pediatrics, Stanford University School of Medicine, 300 Pasteur Drive, G312, Stanford, CA 94305, USA.
| | - Donald Jungkind
- St. George's University School of Medicine, Grenada, West Indies
| | - Angelle Desiree LaBeaud
- Department of Pediatrics, Stanford University School of Medicine, 300 Pasteur Drive, G312, Stanford, CA 94305, USA
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Wahid B, Ali A, Rafique S, Idrees M. Global expansion of chikungunya virus: mapping the 64-year history. Int J Infect Dis 2017; 58:69-76. [PMID: 28288924 DOI: 10.1016/j.ijid.2017.03.006] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/03/2017] [Accepted: 03/07/2017] [Indexed: 10/20/2022] Open
Abstract
Chikungunya virus (CHIKV) is a mosquito-transmitted alphavirus that is emerging as a global threat because of the highly debilitating nature of the associated disease and unprecedented magnitude of its spread. Chikungunya originated in Africa and has since spread across the entire globe causing large numbers of epidemics that have infected millions of people in Asia, the Indian subcontinent, Europe, the Americas, and Pacific Islands. Phylogenetic analysis has identified four different genotypes of CHIKV: Asian, West African, East/Central/South African (ECSA), and Indian Ocean Lineage (IOL). In the absence of well-designed epidemiological studies, the aim of this review article was to summarize the global epidemiology of CHIKV and to provide baseline data for future research on the treatment, prevention, and control of this life-threatening disease.
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Affiliation(s)
- Braira Wahid
- Centre for Applied Molecular Biology, 87 West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
| | - Amjad Ali
- Centre for Applied Molecular Biology, 87 West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
| | - Shazia Rafique
- Centre for Applied Molecular Biology, 87 West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
| | - Muhammad Idrees
- Centre for Applied Molecular Biology, 87 West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan; Vice Chancellor Hazara University, Mansehra, Pakistan.
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Marques CDL, Duarte ALBP, Ranzolin A, Dantas AT, Cavalcanti NG, Gonçalves RSG, Rocha Junior LFD, Valadares LDDA, Melo AKGD, Freire EAM, Teixeira R, Bezerra Neto FA, Medeiros MMDC, Carvalho JFD, Santos MSF, Océa RADLC, Levy RA, Andrade CAFD, Pinheiro GDRC, Abreu MM, Verztman JF, Merenlender S, Ribeiro SLE, Costa IPD, Pileggi G, Trevisani VFM, Lopes MIB, Brito C, Figueiredo E, Queiroga F, Feitosa T, Tenório ADS, Siqueira GRD, Paiva R, Vasconcelos JTS, Christopoulos G. Recomendações da Sociedade Brasileira de Reumatologia para diagnóstico e tratamento da febre chikungunya. Parte 1 – Diagnóstico e situações especiais. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.05.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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